Long-term evaluation of interdigital neuroma treated by surgical excision

Foot Ankle Int. 2008 Jun;29(6):574-7. doi: 10.3113/FAI.2008.0574.

Abstract

Background: We examined a large cohort of patients who had interdigital neurectomy and evaluated their clinical outcomes by using a previously developed scoring system as well as a visual analog scale (VAS). In addition, we wanted to identify risk factors that may lead to poorer outcomes.

Materials and methods: A retrospective review identified 232 patients who had neuroma excision between 1994 and 2004, after failure of conservative treatment. Each patient was contacted via mail and given a Neuroma Clinical Evaluation Score survey as well as a visual analog score. Each patient received a unique identification number, allowing the evaluation process to be single-blinded.

Results: Of the 232 patients contacted, 120 (52%) returned their completed surveys. The average Giannini neuroma score was 53: 61 feet (51%) had good or excellent results, 12 (10%) had fair results, and 48 (40%) had poor results. The average VAS score was 2.5. The only significant (p = 0.027) difference in outcome was the location of the neuroma: second webspace had worse outcomes than third webspace neuromas on both the VAS and neuroma score.

Conclusion: This retrospective review identified location in the second webspace as a possible prognostic indicator of poor outcome, but the more important finding may be that outcomes of neuroma excision do not appear to be as successful at long-term followup as previously reported.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Foot Diseases / pathology
  • Foot Diseases / surgery*
  • Forefoot, Human*
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Neuroma / pathology
  • Neuroma / surgery*
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / etiology
  • Retrospective Studies
  • Shoes
  • Time Factors
  • Treatment Outcome